Individual
JOHANNA NEBEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
11751 S LAWLER AVE, ALSIP, IL 60803-4931
(708) 371-5351
Mailing address
16550 GRANTS TRL, ORLAND PARK, IL 60467-8724
(708) 612-2481
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242.004965
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14338467
ASHA
—
01
—
242.004965
LICENSED SPEECH LANGUAGE PATHOLOGY TEMPORARY
IL
Enumeration date
09/03/2019
Last updated
09/03/2019
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